|THE MCH TRAINING PROGRAM: AN EVALUATION
JEAN ATHEY, PH.D. LAURA KAVANAGH, M.P.P. KAREN BAGLEY
Jean Athey, Health Policy Resources
Group, LLC, served as a consultant to NCEMCH on th e
MCH Training Program Evaluation. Laura Kavanagh, M.P.P., former NCEMCH
associate director of evaluation, directed the MCH Training Program Evaluation
until February 2001. Karen Bagley is a research associate in the Division
of Policy at NCEMCH.
National Center for Education in Maternal
and Child Health October 2001
Cite as : Athey J, Kavanagh L, Bagley K. 2001. The MCH Training Program: An Evaluation. Arlington, VA: National Center for Education in Maternal and Child Health.
The MCH Training Program: An Evaluation © 2001 by National Center for Education in Maternal and Child Health and Georgetown University. Written requests for permission to duplicate and use all or part of the information and illustrations contained in this publication should be sent to NCEMCH at the address below. NCEMCH cannot grant permission to use photographs or to reproduce any material in the text noted as having been reprinted or adapted from another source (contact the original source for permission to reproduce these materials).
The mission of the National Center for Education in Maternal and Child Health
is to provide national leadership to the maternal and child health community
in three key areas—program development, policy analysis and education,
and state-of-the-art knowledge—to improve the health and well-being
of the nation's children and families. The Center's multidisciplinary staff
work with a broad range of public and private agencies and organizations
to develop and improve programs in response to current needs in maternal
and child health, address critical and emergent public policy issues in
maternal and child health, and produce and provide access to a rich variety
of policy and programmatic information. Established in 1982 at Georgetown
University, NCEMCH is part of the Georgetown Public Policy Institute. NCEMCH
is funded primarily by the U.S. Department of Health and Human Services
through the Health Resources and Services Administration's Maternal and
Child Health Bureau.
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This publication has been produced by the National Center for Education in Maternal and Child Health under its cooperative agreement (MCU-119301) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services.
Training Program Priorities and Definitions
Chapter 1: Introduction and Methodology
The Training Program and the MCH Mission
Goals of the MCH Training Program
Needs Addressed by the MCH Training Program
Focusing the Evaluation
Chapter 2: A Statistical Snapshot of the MCH Training Program
MCH Training Program Expenditures
Resources Devoted to Trainees
Resources Utilized for Faculty Leadership
Distribution of MCH Training Program Grants
Chapter 3: Training for Leadership
Differences in Leadership Training Among Projects
Aspects of Training for Leadership
Assessing Project Success in Training Leaders
Chapter 4: Supporting Faculty in Leadership Roles
She MCH Training Program Model of Leadership Versus the University Model
Collaboration and the Interdisciplinary Approach
Fostering Change Within Universities
The Need for MCH Faculty Leaders
Chapter 5: Contributing to Advances in the Field
Nurturing New Professional Subspecialties
Influencing Professional Associations
Developing Innovations in Treatment and Services
Serving as a Voice for Children
Chapter 6: Promoting Collaboration
Technical Assistance, Consultation, and Continuing Education
Collaboration Across Projects and with Nonfunded Universities
Collaboration with Title V Programs
Chapter 7: The Economics of MCH Training
The Role of Tuition in Academic Decision-Making
The Role of Other Funding Sources in Academic Decision-Making
The Impact of Reimbursement on Clinical Training
Leveraging of MCH Training Program Grants
Chapter 8: Recommendations
Planning, Assessment, and Evaluation
Budget Policies and Guidelines
MCH Training Program Evaluation Project Advisory Committee Members
Site-Visited Projects and Project Directors
Additional Information on Interviews with Former Trainees
Maternal and Child Health Bureau Long-Term Training Program Priorities,
Median Awards by Priority Area, FY 1999
Trainees Supported by MCH Training Grants, FY 1999
Faculty Supported by MCH Training Grants, FY 1999
Demographics of Former Trainee Sample and Respondents
Current Employment of Former Trainees
Former Trainees’ Participation in Leadership Activities
MCH Training Program Logic Model
Allocation of Training Program Funds Among Priorities, FY 1999
Training Program Grantee Budgets, FY 1999
MCHB Training Grant Sites, FY 1999
Former Trainees Still Practicing in MCH Field
Job Change After Completing MCH Training
Job Change Attributed to MCH Training
Former Trainees Who Had a Faculty Mentor
Importance of Faculty Mentoring to Former Trainees’ Careers
Former Trainees Who Received Continued Mentoring After Training
Former Trainees Who Consider Themselves Leaders in the Field
Leadership by Cohort
Examples of Leadership Activities of Former Trainees
Examples of Recent Leadership Activities of MCH Training Program Grant
Examples of Treatment and Service Innovations
Examples of Policy Work of Grantees
Publications Produced by Supported Faculty and Trainees, FY 1999
Examples of Technical Assistance, Consultation, and Continuing Education
Examples of University-Based Collaborations
Examples of Consultation with Nonfunded Universities
Examples of Collaborations Between Title V Offices and MCH Training Program
IN MEMORIAM: VINCE L. HUTCHINS, M.D., M.P.H
Dr. Vince Hutchins was a key member of the team that worked on this evaluation.
His insights into and knowledge of the Maternal and Child Health (MCH) Training
Program provided direction and guidance to other team members, and his joy
in life and the pleasure he gained from his work were an inspiration. Despite
the fact that he had one of the most illustrious careers possible in MCH,
he was modest and self-effacing. He treated everyone he encountered with
kindness and sensitivity, and he made people
believe in their own abilities. His laughter,his wisdom,and his warmth are
greatly missed. He was a colleague, a teacher, a mentor, and a friend, and
he lives in our hearts.
This report could not have been completed without
the support and assistance of many people. We are especially grateful
to training project directors who organized site visits and graciously
gave of their time, energy, and knowledge. We also appreciate the time
and candor of the individuals interviewed at each site, including faculty,
students, university administrators, and recipients of continuing
education and technical assistance. The information they provided about
the Maternal and Child Health (MCH) Training Program was invaluable. Appendix
B provides a listing of all site-visited projects and project directors.
We extend thanks to the former trainees who shared their MCH Training Program experiences with us, either via telephone or through written responses. They provided valuable insights about the program and described the impact it has had on them personally.
Thanks also go to state Title V directors and MCH regional consultants who participated in focus groups and to other individuals who shared their knowledge of the MCH Training Program, in particular, Jim Papai and Joann Gephardt, R.N. Their thoughtful perspectives enriched this report.
We wish to acknowledge the leadership and support this evaluation received from the Maternal and Child Health Bureau (MCHB), especially Peter van Dyck, M.D., M.P.H., associate administrator; M. Ann Drum, D.D.S., M.P.H., director, Division of Research, Training and Education; and MCH Training Program project officers—Aaron Favors, Ph.D., Nanette Pepper, B.S.R.N., M.Ed., Diana Rule, M.P.H., and Denise Sofka, M.P.H., R.D. In addition, we express our appreciation to training grant recipients, advisory committee members, and MCHB staff who reviewed a draft of this report and offered helpful suggestions.
Finally, this report could not have been completed without the help and support of colleagues at the National Center for Education in Maternal and Child Health. Rochelle Mayer, Ed.D., director, provided guidance in conceptualizing and implementing the study design and perceptive ideas for presenting the findings. The following NCEMCH Publications Department staff and consultants provided editorial and artistic contributions: Carol Adams, M.A., director of publications; Oliver Green, senior graphic designer; and Megan O’Reilly and Beth Rosenfeld, editorial consultants.
TRAINING PROGRAM PRIORITIES AND DEFINITIONS
Brief descriptions of the 13 long-term priorities
of the Maternal and Child Health (MCH) Training Program are provided below,
along with abbreviations and acronyms that are commonly used throughout
Leadership Education in Adolescent Health (LEAH)
The purpose of the LEAH priority is to provide interdisciplinary leadership training, faculty development, continuing education, scholarship, technical assistance, and collaboration with MCH programs, Title V programs in state departments of public health, state adolescent health coordinators, policymakers, and professional organizations concerned with the health of adolescents. Leadership training produces the next generation of leaders who will influence and train clinicians, public policy and public health experts, investigators, and educators. All of these individuals will move the field forward by improving clinical services, program development, and research/evaluation. The professionals trained include physicians, nurses, social workers, nutritionists, and psychologists.
Leadership Education in Neurodevelopmental and Related Disabilities (LEND)
The LEND priority trains individuals to improve the health of infants, children, and adolescents who have, or are at risk for, developing neurodevelopmental or related disabilities. LEND prepares trainees from a wide variety of professional disciplines to assume leadership roles and to ensure high levels of clinical competence. LEND objectives include the following: (1) to advance the knowledge and skills of the full range of child health professionals in order to improve health care delivery systems for infants, children, and adolescents with developmental disabilities; (2) to provide high-quality education for health professionals; (3) to provide a wide range of health professionals with the skills needed to foster a communi-ty-based partnership of health resources and community leadership; and (4) to promote innovative practice models that enhance cultural competence, partnerships among disciplines, and family-cen-tered approaches to care. Professionals trained include physicians, nurses, social workers, nutritionists, speech-language pathologists, audiologists, pediatric dentists, psychologists, occupational therapists, physical therapists, and health administrators. Recently, parents of infants, children, and adolescents with neurodevelopmental disabilities have been added to the faculty of LEND projects as consultants.
Pediatric Pulmonary Centers (PPC)
Pediatric pulmonary centers prepare health professionals for leadership roles in the development, enhancement, and improvement of community-based, family-centered care for infants, children, and adolescents with chronic respiratory diseases, including asthma. PPCs collaborate with other MCH agencies and professional organizations in the development of materials of regional and national significance, such as professional education materials and clinical practice guidelines, and in the provision of continuing education. They also engage in active partnerships with state and local health agencies and health professionals and serve as models of excellence in training, service delivery, and research related to the prevention and treatment of chronic respiratory conditions in infants, children, and adolescents. Professionals trained include physicians, nurses,nutritionists,pharmacists,respiratory care practitioners, and social workers.
Schools of Public Health (SPH)
Training projects in schools of public health aim to (1) educate future leaders and assist current leaders in solving MCH public health problems; (2) discover and test solutions to these problems by conducting applied research; and (3) improve the health status of women, infants, children, and adolescents through technical assistance to communities. The programs use a competency-based curriculum designed to train students to become leaders in public health practice, research, planning, policy development, and advocacy.
The purpose of behavioral pediatrics training projects is to enhance behavioral, psychosocial, and developmental aspects of general pediatric care. The projects support fellows in behavioral pediatrics to prepare them for leadership roles as teachers, researchers, and clinicians. In addition, these projects provide pediatric practitioners, residents, and medical students with essential biopsychosocial knowledge and clinical expertise.
The communication disorders priority trains speech-language pathologists and audiologists to provide comprehensive services to infants, children, and adolescents and to promote the advancement of the field through information and knowledge dissemination. Speech-language pathologists and audiologists are trained for leadership roles in education, service, research, administration, and advocacy.
Historically Black Colleges and Universities (HBCU)
This priority has a dual purpose: (1) to enhance the education and training of residents in obstet-rics,adolescent gynecology,family practice,and pediatrics for the provision of primary care in com-munity-based settings, especially for underserved populations; and (2) to stimulate the interest of African-American and Hispanic high school and college students in MCH-related professions through mentorship programs.
The purpose of the nursing priority is to provide postprofessional graduate training in nurse-mid-wifery, pediatric nursing, and adolescent nursing, with the goal of ensuring MCH leadership in academia and community-based health programs. The nursing projects also provide continuing education to nurses in the field.
This priority aims to promote healthy nutrition of infants, children, and adolescents by providing graduate training to nutritionists and registered dietitians who are prepared for public health leadership roles. In addition, short-term training (e.g., 1day continuing education, week-long intensive courses, 3-week to 3-month practica) is provided to individuals from a variety of disciplines, including obstetricians, pediatricians, nurses, and nutritionists, focused on both clinical and public health approaches to maternal and infant, child, and adolescent nutrition.
This priority provides postdoctoral training for pediatric dentists designed to foster leadership in administration, education, and oral health services. Attention is focused on infants, children, and adolescents with special health care needs, including those with behavioral problems. In addition, high-risk populations, such as children of migrant farm workers, Native American children, and children from low-income families, are targeted for provision of clinical dental services.
Pediatric Occupational Therapy
Increasing access to developmental programs for infants, children, and adolescents with disabilities, and ensuring that such programs are culturally competent and community-based, are the goals of this priority. Projects train master’s and doctoral students for leadership roles and strive to affect occupational therapy training programs nationwide through the development and dissemination of educational resources, continuing education, and technical assistance.
Pediatric Physical Therapy
Pediatric physical therapists are needed to improve the functioning, level of independence, and quality of life of the increasing numbers of infants, children, and adolescents with disabilities and special health care needs. This priority provides postprofessional graduate training, including degree programs at the master’s and doctoral levels, as well as nondegree offerings for pediatric physical therapists, in order to ensure leadership in education, services, research, and administration. These projects also serve as national and regional resources for continuing education.
The social work priority aims to establish centers of excellence
that promote public health training for social workers and support trainees
to become leaders in their fields. Both master's level and doctoral
training are supported. These centers also serve as regional resources
for continuing education, and they disseminate educational materials
to other social work programs nationwide.